State pilot program tests umbilical cords for opioids, other drugs

INDIANAPOLIS, Ind. – Many delivering hospitals in Indiana took part in a pilot program last year to find out how many pregnant women were on powerful and dangerous drugs. The Neonatal Abstinence Syndrome (NAS) program found 14.37 percent of umbilical cords screened were positive with opioids.

According to a spokesperson with the Indiana State Department of Health (ISDH), the Indiana General Assembly gave the department a task of finding out how prevalent NAS was in Indiana newborns.

In 2016, hospitals began voluntary pilot programs to effectively identify, collect and report NAS data. Last year, the program expanded to 21 hospitals in the state.

"When a pregnant woman arrives at the hospital for delivery, hospital personnel will conduct a standardized and validated verbal screening on all women," said the spokesperson. "Medical staff will request that the woman consent to a urine toxicology screening for anyone with a positive screening result at any point during her pregnancy including presentation for delivery. Babies whose mothers had a positive verbal screen or positive toxicology screening results or babies whose mothers did not consent to the toxicology screen will be screened using urine, cord or meconium depending upon the results of the maternal screening."

The ISDH reported that 2,938 umbilical cords were tested last year. The 14.37 percent found with opioids is higher than the national average of 10.8 percent.

"It’s important to note that these results are just snapshots and should not be represented as a statewide rate," said the ISDH spokesperson. "Because universal screening of babies is not being conducted, ISDH believes these numbers are an under representation of true prevalence."

Screenings also found that 18.41 percent tested positive for cannabinoids.

Source: Indiana State Department of Health

“I don’t know if I have seen significant research that tells us that there is significant effects on the baby with marijuana use," said Aspire Indiana Health COO Syd Ehmke. "I’m not saying there’s not, but I’m saying it’s nothing like a baby that has been addicted to opiates.”

The March of Dimes defines NAS as, "a group of conditions caused when a baby withdraws from certain drugs its exposed to in the womb before birth."

Opioids are most often the cause of the conditions.

“They’re just not thriving well, they don’t eat well, and they fail to grow," said Ehmke. "It's high-pitched scream and crying, because they’re in pain. They're uncomfortable. It’s an abrupt withdraw of the opiate from their system.”

For 2018, 29 of the state's 89 delivering hospitals are in the program. Ehmke said if all the hospitals get involved, the state could better under the issue and how more data to get outside support.

“This is how you get grants," she said. "This is how the federal government stands up and takes notice, when you have statistics like this. You say, this is the problem we have in Indiana, what can do you about it.”

To expand the program statewide would require state legislation, said the ISDH spokesperson. The data has been taken to state lawmakers to help them better decide how to handle the program going past 2018.

Ehmke said the data out now can help healthcare workers better connect with patients, who would benefit from seeking treatment, no matter how far a woman is into her pregnancy.

“Mommies want to do the right thing too," Ehmke said. "That’s why I think if we have the conversation and we are asking people about their drug use before getting pregnant and having these conversations, to use data like that, I think it’s extremely worthwhile.”

Ehmke added earlier is always better to seek help and many NAS symptoms can go away or be reduced if the mother is no longer on the drugs.